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Panosteitis:
Growing Pains for the Large Breed Puppy

Oscar used to be a happy puppy. When his human parents first got him, he looked like a little black and tan bear cub but he has since grown into a gangly adolescent German Shepherd Dog. And he is no longer happy.

Instead of playing like a nine-month-old pup ought to, he limps on a front leg. His owners could swear that last month it was the other front leg and they cannot think of any way he might have injured himself playing. When they pick up the leg to feel it, he cries sharply. He gets better for several weeks and then it starts all over again. The vet has prescribed pain releivers for the bad days and has told Oscar's owners that they must wait out this condition. Oscar has panosteitis.

Panosteitis, also referred to as "enostosis," "cosinophilic panosteitis," or simply "panno," is an orthopedic disease of large breed pups generally 6–18 months of age. The German Shepherd Dog is especially predisposed.

The disease stems from a proliferation of bone material inside the shafts of the long bones of the legs. Any or all four legs can be affected. Sometimes the lameness is accompanied by fever and general malaise and, after a flare-up, the condition wanes only to recur a few weeks later in another leg. The diagnosis is easy as bone proliferation shows up like a beacon on a radiograph but we still do not know what causes this proliferation in the first place.

Viral Infection?

In 1960, a study was published in which bone marrow from dogs with panosteitis was injected into bone marrow cavities of healthy dogs. The healthy dogs came down with panosteitis within three weeks. This was strong evidence for an infectious agent yet no bacteria have been cultured from lesions either in that study or since. A virus would explain the ability to transmit the disease, the fact that some dogs seem to get feverish with the disease, and the lack of other obvious infectious agents, but it would not explain why small breed dogs are virtually untouched by the disease. No virus has successfully been isolated from any dog with panosteitis but the theory of viral infection is still very much alive among researchers studying this condition.

The good news with panosteitis is that it is a disease of adolescence. By the time patients like Oscar are two years old, the condition has almost always run its course. There is no specific treatment other than medication to relieve pain and waiting for adulthood to alleviate the condition.

Dr. Wendy Brooks graduated from the University of California at Davis School of Veterinary Medicine in 1988 after finishing her undergraduate studies at Mount Holyoke College in western Massachusetts in 1983. In 1995, she received certification as a Specialist in Canine and Feline Practice from the American Board of Veterinary Practitioners. She currently practices in the West Los Angeles area in addition to answering pet care-related questions on-line through the Pet Care Forum area of America On-Line.


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